Types of Tonsillitis: Catarrhal, Lacunar, Follicular

Three in the morning, the child sits on the bed and refuses to swallow even water. Parents understand: they need to figure out what is happening and decide when to seek help. Below — about how the forms of tonsillitis differ and what "purulent" or "non-purulent" means.

What tonsillitis is and why it is called acute tonsillitis

The tonsils are clusters of tissue deep in the mouth, one on each side. Together with the adenoids, they belong to the lymphatic system and work as traps for microbes that enter through the mouth and nose. When this tissue becomes inflamed, it is tonsillitis.

In medical language, the same condition is called acute tonsillitis; "angina" is the everyday word. The same term is also used for an exacerbation of chronic tonsillitis. The cause is more often viral, but bacteria are also in play: in more than half of cases the main culprit is group A β-hemolytic streptococcus, less often staphylococcus, pneumococci, or fungi of the genus Candida. Among viruses, adenoviruses, Coxsackie virus, and herpes are named.

Children get sick more often: the bacterial form is more typical for ages 5–15, the viral form for young children. Adults also get sick, but less often. Clinically, catarrhal, lacunar, parenchymatous, follicular, and membranous forms are distinguished.

Catarrhal tonsillitis: signs and features

It starts acutely: first burning, dryness, and scratchiness in the throat, then mild pain when swallowing. The temperature is usually subfebrile, the blood test shows minor inflammatory changes, and there are signs of astheno-vegetative syndrome.

This is essentially tonsillitis without pus: the description of the catarrhal form includes neither coatings nor purulent spots on the tonsils. Symptoms of tonsillitis usually last 3–4 days, although they can last longer.

Lacunar and follicular tonsillitis: how they differ

These are two separate clinical forms in the classification. Exactly how they differ is determined by the doctor during examination.

More severe tonsillitis in general may present with swollen and red tonsils, white or yellowish deposits or purulent spots, bad breath, and enlarged tender lymph nodes in the neck. But these are general signs of more pronounced inflammation, not a distinguishing feature of the lacunar or follicular form.

Purulent tonsillitis: signs, purulent plugs, and causes

"Purulent tonsillitis" is not a line in the classification but a description of what is visible in the throat: purulent spots or white deposits on the tonsils, white or yellowish coating, bad breath, tender lymph nodes in the neck. The cause is not determined by appearance: the doctor takes a swab from the tonsils and the posterior pharyngeal wall — a rapid streptococcal test, a culture, or both.

Purulent spots and pain that makes it hard to eat and drink are a reason not to wait a week but to see a doctor. The appearance of the coating cannot determine whether it is a virus or a bacterium — that is decided by a test.

Is tonsillitis an infectious disease or not, and when a doctor is needed

Tonsillitis is an infectious disease. At the same time, tonsillitis itself is not contagious; what is contagious are the infections that caused it, such as a cold or flu. The viruses and bacteria that cause tonsillitis are contagious; doctors advise in this case to stay home while there is a fever and poor well-being, to use tissues when coughing and sneezing, and to wash hands.

At the appointment, the doctor asks about symptoms, examines the throat and neck, and checks the lymph nodes. Sometimes a blood test for infectious mononucleosis is added if the symptoms are severe or do not resolve for a long time.

Situations when a visit to the doctor is not postponed:

• in a child, sore throat lasts longer than two days;
• swallowing is painful or difficult, and the child refuses to drink;
• white deposits or purulent spots are visible on the tonsils;
• lymph nodes in the neck are enlarged and painful, and bad breath has appeared;
• episodes recur again and again.

Complications are rare but do occur: a pus-filled cavity — an abscess — forms between the tonsil and the pharyngeal wall.

Tonsillitis itself is not a reason to call an ambulance; 103 or 112 are needed if the sore throat sharply intensifies, the mouth or throat swells, it is difficult to speak, impossible to swallow, difficult to breathe, the mouth does not open, or drooling has begun. These are signs of an abscess, and help is needed immediately.

This material is for reference: it helps to understand what is happening but does not replace a doctor's examination — especially with children, who cannot always explain exactly what hurts.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer